# US 9,750,878 B2 · Closed-loop control of glucose according to a predicted blood glucose trajectory

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- Number: US 9,750,878 B2
- Document ID: US9750878B2
- Status: Granted
- Kind: B2
- Application number: 14/103,522
- Filed: 2013-12-11
- Published: 2015-06-11
- Granted: 2017-09-05
- Earliest claimed: 2013-12-11
- Assignees: Medtronic MiniMed, Inc.
- Applicants: Medtronic Minimed, Inc.
- Inventors: Anirban Roy; Desmond Barry Keenan; Paul H. Kovelman
- Web page: https://patentgrep.com/patent/US9750878B2

## CPC

- A61M 5/1723: {using feedback of body parameters, e.g. blood sugar or pressure}
- A61B 5/14532: {for measuring glucose, e.g. by tissue impedance measurement}
- A61B 5/4839: {combined with drug delivery}
- A61B 5/7275: {Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor}
- G16H 20/17: delivered via infusion or injection
- A61B 5/6849: {in combination with a needle set}
- A61M 5/14244: {adapted to be carried by the patient, e.g. portable on the body}
- A61M 2205/33: Controlling, regulating or measuring
- A61M 2205/50: with microprocessors or computers
- A61M 2230/201: Glucose concentration
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Presented here are techniques for controlling glucose levels of a patient based on predicted time to a target glucose level. One methodology predicts a trajectory of the blood glucose level based on past observations of the blood glucose level, determines a cost expression based on the trajectory, and affects a future command to an infusion pump to affect a cost value according to the cost expression. Another methodology defines a target blood glucose concentration level for the patient, observes a current blood glucose concentration for the patient based on signals received from a blood-glucose sensor, and predicts a duration of time for the patient's blood glucose concentration to reach the target blood glucose concentration level based on the observed current blood glucose concentration.

## Claims

### Claim 1

A method comprising:
predicting a trajectory of a blood glucose level of a patient based, at least in part, on past observations of said blood glucose level;
determining a cost expression based, at least in part, on said predicted trajectory,
wherein said cost expression is based, at least in part, on a first duration of time that said trajectory is predicted to be under a lower bound blood glucose limit of a target blood glucose concentration range, and is also based, at least in part, on a second duration of time that said trajectory is predicted to be above an upper bound blood glucose limit of said target blood glucose concentration range, the first duration of time corresponding to a predicted hypoglycemic time period, and the second duration of time corresponding to a predicted hyperglycemic time period,
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range under the lower bound blood glucose limit during said first duration of time, and
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range above the upper bound blood glucose limit during said second duration of time; and
affecting at least one future command to at least one infusion pump so as to shorten the predicted hypoglycemic time period and to shorten the predicted hyperglycemic time period according to said cost expression.

### Claim 2 (depends on 1)

The method of claim 1, wherein said at least one infusion pump comprises an insulin infusion pump.

### Claim 3 (depends on 1)

The method of claim 1, wherein said at least one infusion pump comprises an infusion pump for glucagon.

### Claim 4 (depends on 1)

The method of claim 1, wherein said cost expression is defined to cover a set duration in the future.

### Claim 5 (depends on 1)

The method of claim 1, wherein said predicting, said determining the cost expression and said affecting said at least one future command is performed on command intervals.

### Claim 6

An apparatus comprising:
one or more infusion pumps to infuse a substance into a body in response to commands; and
a controller to:
predict a trajectory of a blood glucose level of said body based, at least in part, on past observations of said blood glucose level;
determine a cost expression based, at least in part, on said predicted trajectory,
wherein said cost expression is based, at least in part, on a first duration of time that said trajectory is predicted to be under a lower bound blood glucose limit of a target blood glucose concentration range, and is also based, at least in part, on a second duration of time that said trajectory is predicted to be above an upper bound blood glucose limit of said target blood glucose concentration range, the first duration of time corresponding to a predicted hypoglycemic time period, and the second duration of time corresponding to a predicted hyperglycemic time period,
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range under said lower bound blood glucose limit during said first duration of time, and
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range above said upper bound blood glucose limit during said second duration of time; and
affect at least one future command to said one or more infusion pumps so as to shorten the predicted hypoglycemic time period and to shorten the predicted hyperglycemic time period wherein the at least one future command controls the system operation according to said cost expression.

### Claim 7 (depends on 6)

The apparatus of claim 6, wherein said controller is further to generate said commands on discrete command intervals.

### Claim 8 (depends on 6)

The apparatus of claim 6, wherein said one or more infusion pumps comprises an insulin infusion pump.

### Claim 9

An article comprising:
a non-transitory storage medium comprising machine-readable instructions executable by a special purpose computing apparatus to:
predict a trajectory of a blood glucose level of the body based, at least in part, on past observations of said blood glucose level;
determine a cost expression based, at least in part, on said predicted trajectory,
wherein said cost expression is based, at least in part, on a first duration of time that said trajectory is predicted to be under a lower bound blood glucose limit of a target blood glucose concentration range, and is also based, at least in part, on a second duration of time that said trajectory is predicted to be above an upper bound blood glucose limit of said target blood glucose concentration range, the first duration of time corresponding to a predicted hypoglycemic time period, and the second duration of time corresponding to a predicted hyperglycemic time period,
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range under said lower bound blood glucose limit during said first duration of time, and
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range above said upper bound blood glucose limit during said second duration of time; and
affect at least one future command to one or more infusion pumps so as to shorten the predicted hypoglycemic time period and to shorten the predicted hyperglycemic time period according to said cost expression.

### Claim 10

An apparatus comprising:
a means for predicting a trajectory of a blood glucose level of a patient based, at least in part, on past observations of said blood glucose level;
a means for determining a cost expression based, at least in part, on said predicted trajectory,
wherein said cost expression is based, at least in part, on a first duration of time that said trajectory is predicted to be under a lower bound blood glucose limit of a target blood glucose concentration range, and is also based, at least in part, on a second duration of time that said trajectory is predicted to be above an upper bound blood glucose limit of said target blood glucose concentration range, the first duration of time corresponding to a predicted hypoglycemic time period, and the second duration of time corresponding to a predicted hyperglycemic time period,
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range under said lower bound blood glucose limit during said first duration of time, and
wherein said cost expression is further based, at least in part, on a degree or extent to which said predicted blood glucose level is to extend outside of the target blood glucose concentration range above said upper bound blood glucose limit during said second duration of time; and
a means for affecting at least one future command to at least one infusion pump to infuse a substance into the patient, and so as to shorten the predicted hypoglycemic time period and to shorten the predicted hyperglycemic time period according to said cost expression.